Individual
MRS. MERRILY YVONNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
409 EARHART ST, MEDFORD, OR 97501-7827
(541) 858-8887
Mailing address
409 EARHART ST, MEDFORD, OR 97501-7827
(541) 858-8887
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5083
OR
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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